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Systolic Dysfunction in Heart
Failure
Michael Feneley, MD
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There are many causes of heart failure.
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And, there are many ways to look at heart
failure. |
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Systolic failure and it’s causes. |
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Systolic failure can be segmental (left
with thrombus) or global (right). |
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Coronary artery disease must be excluded
every time there is systolic failure. |
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As we saw in the pathologic segment,
infarction can remodel the left ventricle. |
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Echo can measure many things. All may
be useful, but it is impossible to do all. |
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Even more can be measured to assess systolic
failure. |
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Overall ejection fraction is most common. |
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EF indicates prognostic information. |
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Echo in Context |
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Most big trials indicate that treatment
with ACE Inhibition help outcome. |
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Stress echo has a role in detecting ischemia
as the cause, particularly silent ischemia. |
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Viability by stress methods help determine
prognosis. |
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Like everything, there are limitations
to measurement. |
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Contrast may help to overcome poor visualization
of borders. |
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Regional, or segmental changes can also
be assessed. |
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And, of course, we can score the walls
movement. |
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Wall scores are useful for prognostic
information. |
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Color wall tracking can help with segmental
wall abnormalities. |
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Doppler tissue imaging can help also
by showing velocity of walls, not just direction of motion. |
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This is the concept of remodeling. |
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The recent Guidelines stress the use
of echocardiography. |
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Echo in Context |
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Echo in Context |
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Here are some “tips”. |
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2004
